Understanding and managing Traumatic Brain Injury (TBI) in a South Auckland prison - trialling a psychological intervention for male sentenced prisoners with a history of TBI.

A pilot Randomised Control Trial (RCT) of group Cognitive Behavioural Therapy (CBT)to assist  prisoners to manage mood and persistent symptoms following TBI. A manualised programme will be delivered to cohorts of 12 sentenced male prisoners who have a criminal history of violence, burglary or sexual offences. The manualised programme has been adapted from a programme developed for anger management. The programme will be administered by a Registered Psychologist and Intern Psychologist within the health space inside the prison. The programme is manualised and will be delivered in 10 x 1 hour sessions, across 5 weeks. The study will involve 72 men in total. The sessions are summarised as below: 1 Introduction of facilitator and session structure Housekeeping and group rules – confidentiality and respect Rationale for this intervention- discuss CBT and Mindfulness for TBI Homework is to develop personal goals for the programme 2 Psychoeducation on the importance of emotional regulation following TBI Introduction of CBT 5 part model and the role of emotions in driving behaviour 3 Psychoeducation on relationship between thoughts, emotions and behaviour using 5 part CBT model 4 Introduction of the concept of mindfulness. Mindfulness exercises in group using Acceptance and Commitment Therapy template 5 Application of mindfulness to thoughts- psychoeducation on thought diffusion strategies 6 Application of mindfulness to emotional regulation – Exercise in acceptance of emotions 7 Standard session structure Integration of CBT and Mindfulness to understand relationship between thoughts and emotions and how this drives behavioural patterns 8 Introduction of the importance of life values and how they link to personal goals 9 Every day use of CBT techniques and Mindfulness practice to make alternative choices based on values/goals 10 Overview of programme Feedback and discussion. The group members will be encouraged to complete all sessions but are able to withdraw consent to participate at any time. Successful completion will be considered attendance at 80% of the sessions. A register will be maintained noting attendance or absence.